Left bundle branch block-induced cardiomyopathy: a diagnostic proposal for a poorly explored pathological entity. (15th January 2020)

• Record Type: Journal Article
• Authors: Sanna, Giuseppe D.; Merlo, Marco; Moccia, Eleonora; Fabris, Enrico; Masia, Stefano L.; Finocchiaro, Gherardo; Parodi, Guido; Sinagra, Gianfranco
• Is Part Of: International journal of cardiology. Volume 299(2020)
• Page Start: 199
• Page End: 205
• Publication Date: 2020-01-15
• Subjects: Left bundle-branch block (LBBB) -- Dilated cardiomyopathy (DCM) -- Left bundle-branch block-induced cardiomyopathy -- Dyssynchronopathy -- Cardiac resynchronization therapy (CRT); Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2019.06.008
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Despite being increasingly recognized as a specific disease, at the present time left bundle branch block (LBBB)-induced cardiomyopathy is neither formally included among unclassified cardiomyopathies nor among the acquired/non-genetic forms of dilated cardiomyopathy (DCM). Currently, a post-hoc diagnosis of LBBB-induced cardiomyopathy is possible when evaluating patients' response to cardiac resynchronization therapy (CRT). However, an early detection of a LBBB-induced cardiomyopathy could have significant clinical and therapeutic implications. Patients with the aforementioned form of dyssynchronopathy may benefit from early CRT and overall prognosis might be better as compared to patients with a primary muscle cell disorder (i.e. "true" DCM). The real underlying mechanisms, the possible genetic background as well as the early identification of this specific form of DCM remain largely unknown. In this review the complex relationship between LBBB and left ventricular non-ischaemic dysfunction is described. Furthermore, a multiparametric approach based on clinical, electrocardiographic and imaging red flags, is provided in order to allow an early detection of the LBBB-induced cardiomyopathy. Highlights: LBBB-induced cardiomyopathy represents a distinct nosological entity. It is not formally included among cardiomyopathies. A multiparametric approach based on several red flags may favor an early detection. Patients with LBBB-induced cardiomyopathy may benefit from early CRT. Further studies are needed to better characterize this poorly explored pathological entity.